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Individual

DR. CLEOPHUS BENSON CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
5695 KING CENTRE DR, SUITE B100, ALEXANDRIA, VA 22315-5744
(703) 719-9824
(703) 719-6206
Mailing address
5695 KING CENTRE DR, SUITE B100, ALEXANDRIA, VA 22315-5744
(703) 719-9824
(703) 719-6206

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401003822
VA

Other

Enumeration date
09/14/2006
Last updated
06/26/2025
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